Loading...
Excessive daytime sleepiness can occur even with adequate sleep and without an obvious etiology such as depression or narcolepsy. Other than modafinil, no substances have been studied in controlled trials for hypersomnia. This study is based on the observation that many hypersomnia patients have an endogenous positive allosteric modulator of GABA-A receptors in cerebrospinal fluid and on clinical anecdotes that the antibiotic clarithromycin, which exhibits negative allosteric modulation of GABA-A receptors in vitro, improves sleepiness in these patients.
Twenty-two patients with idiopathic hypersomnia were randomized to 2 weeks of clarithromycin (500 mg twice daily) or placebo; after a 1-week washout, they were crossed to the other arm. All …